Which of the following sets of adverse effects is most likely to occur from this treatment? A 72-year-old man, recently diagnosed with Alzheimer’s disease, has been prescribed a drug which might help to slow the progression of her symptoms.
A. Hypertension, palpitations B. Nausea, vomiting and diarrhea C. Dry mouth, anhydrosis D. Drowsiness, lethargy E. Mydriasis, cycloplegia
Nausea, vomiting and diarrhea-answer: b
(brunton, pp 539, koda-kimble pp.100-7)
the drugs most frequently used in alzheimers disease are cholinesterase inhibitors like
donepezil, rivastigmine etc. even if these drugs preferentially inhibit acetylcholinesterase in the
cns, they can cause most of the adverse effects shared by all cholinergic drugs, which are due
to activation of cholinergic receptors. effects affecting the gastrointestinal tract (nausea
vomiting and diarrhea) are the most common.
a, c, d, e) actually these effects are caused by antimuscarinic drugs, not by cholinergic drugs.